Frozen as Good as Fresh for Fecal Transplants for Diarrhea: Study

THURSDAY April 24, 2014, 2014 -- Using frozen material for fecal transplants is as effective as fresh material in curing people with chronic diarrhea caused by recurrent infection with Clostridium difficile bacteria, according to a small new study.

Each year in the United States, C. difficile causes 250,000 infections requiring hospitalization and 14,000 deaths. Fecal transplants treat C. difficile infection by restoring the normal balance of intestinal microbes, the researchers explained.

Previous research has shown that fecal transplants with fresh stool have a success rate of about 90 percent. However, recruiting and screening potential donors of fecal material can be costly and time consuming, the study authors note.

Having a supply of frozen, prescreened donor stool could make fecal transplant available to a much larger number of patients, according to the Massachusetts General Hospital team conducting the study.

The pilot study included 20 patients (three were children) who'd had either three or more bouts of mild to moderate C. difficile infection where antibiotic treatment failed, or had two severe bouts that required hospitalization.

They received frozen stool through the standard colonoscopy method or through a tube inserted in the nose and moved down the throat into the stomach. The treatment success rate was 90 percent, which matches that of transplants using fresh stool, according to the study published online in the journal Clinical Infectious Diseases.

"We found that delivery of a frozen, stored [material] through a nasogastric tube is safe, acceptable to patients and as successful as delivery by colonoscopy -- which requires a preparatory 'clean out,' sedation or anesthesia, and is quite costly," senior author Dr. Elizabeth Hohmann, of the MGH Infectious Diseases Division in Boston, said in a hospital news release.

"Without this treatment option, patients with recurrent C. difficile may have chronic diarrhea -- limiting their quality of life and their ability to maintain weight -- and need to live on chronic antibiotic treatment, which is both expensive and can have other side effects," she added.

"There aren't many things in medicine that have a success rate of more than 90 percent. Insurers may not want to pay for this, but it is very effective, makes patients better quite quickly and saves money overall. While it may never become a first-line treatment, we are starting to consider using it more and more often," Hohmann concluded.

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